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Sglt 2 inhibitors

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https://www.readbyqxmd.com/read/28437153/diabetic-ketoacidosis-in-patients-with-type-2-diabetes-recently-commenced-on-sglt-2-inhibitors-an-ongoing-concern
#1
Mohamed Ahmed, Malachi J McKenna, Rachel K Crowley
OBJECTIVE: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are increasingly used as an adjunctive treatment for type 2 diabetes. We report the occurrence of diabetic ketoacidosis (DKA) in 3 patients with type 2 diabetes recently commenced on SGLT-2 inhibitors. METHODS: Clinical presentation, laboratory data, and treatment outcomes of all 3 cases are described. RESULTS: All 3 patients had documented history of longstanding type 2 diabetes...
April 2, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28435446/cardiovascular-risk-assessment-in-patients-with-diabetes
#2
REVIEW
Marcello Casaccia Bertoluci, Viviane Zorzanelli Rocha
Although patients with diabetes have 2 to 4 times increased risk of cardiovascular morbidity and mortality than individuals without diabetes, recent studies indicate that a significant part of patients are in a lower cardiovascular risk category. Men younger than 35 years, women younger than 45 years, patients with diabetes duration of less than 10 years without other risk factors have a much lower risk than patients who have traditional cardiovascular risk factors, and subclinical or established coronary artery disease (CAD)...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28426260/the-effects-of-intermittent-use-of-the-sglt-2-inhibitor-dapagliflozin-in-overweight-patients-with-type-2-diabetes-in-japan-a-randomized-crossover-controlled-clinical-trial
#3
Kanako Kato, Kunihiro Suzuki, Chie Aoki, Masaaki Sagara, Takafumi Niitani, Sho Wakamatsu, Kazunori Yanagi, Yoshimasa Aso
BACKGROUND: This study examined the effects of short-term administration of the sodium glucose cotransporter 2 (SGLT-2) inhibitor, dapagliflozin, on visceral fat area (VFA) in Japanese patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: In this randomized, crossover, controlled clinical trial, overweight patients with type 2 diabetes were randomized to treatment with 5 mg dapagliflozin for the first (n = 27) or second 12-week study period (n = 29). The parameters evaluated at baseline and after 12 and 24 weeks included blood pressure, hemoglobin A1c (HbA1c), body composition, VFA, and subcutaneous fat area (SFA)...
April 21, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28422431/effect-of-empagliflozin-on-tacrolimus-induced-pancreas-islet-dysfunction-and-renal-injury
#4
J Jin, L Jin, K Luo, S W Lim, B H Chung, C W Yang
An inhibitor of sodium glucose co-transporter type 2 (SGLT-2) is recommended in type 2 diabetes mellitus (DM) but its use is still undetermined in Tacrolimus (TAC)-induced DM. We evaluated the effect of empagliflozin (Em) on TAC-induced pancreatic islet dysfunction and renal injury in experimental model of TAC-induced DM and in vitro. TAC induced a two-fold increase in SGLT-2 expression, while Em decreased SGLT-2 expression and further increased urinary glucose excretion compared to the TAC group. Em reduced hyperglycemia and increased plasma insulin level, pancreatic islet size and glucose-stimulated insulin secretion (GSIS) compared to the TAC group...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28395363/natural-products-as-lead-compounds-for-sodium-glucose-cotransporter-sglt-inhibitors
#5
Wolfgang Blaschek
Glucose homeostasis is maintained by antagonistic hormones such as insulin and glucagon as well as by regulation of glucose absorption, gluconeogenesis, biosynthesis and mobilization of glycogen, glucose consumption in all tissues and glomerular filtration, and reabsorption of glucose in the kidneys. Glucose enters or leaves cells mainly with the help of two membrane integrated transporters belonging either to the family of facilitative glucose transporters (GLUTs) or to the family of sodium glucose cotransporters (SGLTs)...
April 10, 2017: Planta Medica
https://www.readbyqxmd.com/read/28393583/spotlight-on-canagliflozin-300-review-of-its-efficacy-and-an-indirect-comparison-to-other-sglt-2-inhibitors-and-long-acting-glp-1-receptor-agonists
#6
Awadhesh Kumar Singh, Ritu Singh
Both sodium-glucose co-transporter-2 inhibitors (SGLT-2Is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been consistently found to lower blood glucose, body weight and systolic blood pressure (SBP) in patients with type 2 diabetes mellitus (T2DM). While all the SGLT-2Is inhibit glucose reabsorption by blocking SGLT-2 receptor in kidney, dose-dependently, the highest licensed dose of canagliflozin 300-mg has an additional ability to inhibit SGLT-1 receptor in intestine transiently, that may lead to additional inhibition of prandial glucose absorption, unlike other approved highly selective SGLT-2Is...
April 17, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28387100/-about-the-choice-between-a-dpp-4-inhibitor-and-a-sglt-2-inhibitor-tor-treating-type-2-diabetes
#7
REVIEW
A J Scheen, N Paquot
Two new classes of oral antidiabetic agents play an increasing role in the management of type 2 diabetes, dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) and sodiumglucose cotransporters type 2 (SGLT2) inhibitors (gliflozins). After failure of a monotherapy with metformin (first pharmacological choice in type 2 diabetes), both may offer an alternative to the add-on of a sulphonylurea, especially in patients at risk of hypoglycaemia. However, the choice between a DPP-4 inhibitor and a SGLT2 inhibitor is not easy and should be oriented based upon the individual patient characteristics...
December 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28383856/-dapagliflozin-forxiga%C3%A2-sglt-2-cotransporter-inhibitor-as-glucose-lowering-agent-in-type-2-diabetes
#8
REVIEW
A J Scheen
Dapagliflozin, a specific inhibitor of sodium-glu¬cose cotransporters type 2 (SGLT2, inhibits glucose reabsorp¬tion in renal tubules and thus promotes glucosuria. This effect results in a reduction in fasting and postprandial glycaemia and a decrease of glycated haemoglobin (HbA1c), with a minor risk of hypoglycaemia, a weight reduction and a reduction in arterial blood pressure. The efficacy of empagliflozin on HbA1c reduction increases according to the level of hyper¬glycaemia but decreases in patients with renal insufficiency...
October 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28364032/sodium-glucose-transporter-2-inhibition-has-no-renoprotective-effects-on-non-diabetic-chronic-kidney-disease
#9
Qiuyue Ma, Stefanie Steiger, Hans-Joachim Anders
Sodium glucose transporter (SGLT)-2 inhibition has renoprotective effects in diabetic kidney disease. Whether similar effects can be achieved also in non-diabetic kidney disease is speculative. Chronic kidney disease was induced in C57BL/6N mice by feeding an oxalate-rich diet for 14 days, known to induce nephrocalcinosis-related tubular atrophy and interstitial fibrosis without directly affecting the glomerular compartment. Empagliflozin treatment started from day 0 of oxalate feeding had no effect on the decline of glomerular filtration rate, crystal deposition, blood urea nitrogen or serum creatinine levels on day 7 and 14...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28349443/cost-effectiveness-of-liraglutide-versus-dapagliflozin-for-the-treatment-of-patients-with-type%C3%A2-2-diabetes-mellitus-in-the-uk
#10
Gabriela Vega-Hernandez, Radek Wojcik, Max Schlueter
INTRODUCTION: To date there is a lack of economic analysis comparing glucagon-like peptide-1 receptor agonists (GLP-1RAs) to sodium-glucose co-transporter 2 inhibitors (SGLT-2i) for the treatment of type 2 diabetes mellitus (T2DM). Liraglutide and dapagliflozin are the most commonly prescribed GLP-1RA and SGLT-2i in the UK. This analysis investigated the cost-effectiveness of liraglutide 1.2 and 1.8 mg/day compared to dapagliflozin 10 mg/day for the treatment of T2DM in the UK in patients on dual and triple antidiabetic therapy...
March 27, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28299616/promise-of-sglt2-inhibitors-in-heart-failure-diabetes-and-beyond
#11
REVIEW
Pieter Martens, Chantal Mathieu, Frederik H Verbrugge
This review provides mechanistic insight in the pleiotropic effects of sodium-glucose transporter-2 (SGLT-2) inhibitors with particular interest to the pathophysiology of heart failure. The SGLT-2 inhibitor empagliflozin has recently demonstrated an unprecedented 38% reduction in cardiovascular mortality in patients with diabetes. Despite modest effects on long-term glycemic control, highly significant reductions in heart failure admissions and end-stage kidney disease were observed. SGLT-2 inhibitors are the latest approved class of glucose-lowering agents...
March 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28295962/improving-glycemic-control-in-type-2-diabetes-stimulate-insulin-secretion-or-provide-beta-cell-rest
#12
REVIEW
Daniël H van Raalte, C Bruce Verchere
Type 2 diabetes (T2D) is characterized by a gradual decline of pancreatic beta cell function that determines the progressive course of the disease. While beta-cell failure is an important contributor to hyperglycemia, chronic hyperglycemia itself is also detrimental for beta-cell function, likely by inducing prolonged secretory stress on the beta cell as well as through direct glucotoxic mechanisms that have not been fully defined. For years, research has been carried out in search of therapies targeting hyperglycemia that preserve long-term beta-cell function in T2D, a quest that is still ongoing...
March 14, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28295491/national-trends-in-the-treatment-of-diabetic-nephropathy-in-the-united-states
#13
O Ajiboye, J B Segal
WHAT IS KNOWN AND OBJECTIVE: The prevalence of diabetic nephropathy continues to rise and it remains a strong predictor of morbidity and mortality in diabetic patients. Patients diagnosed with diabetic nephropathy are actively excluded from most trials involving diabetic medications and it is important to understand the prescription patterns in this subset of patients with diabetes. METHODS: Using the IMS Health's National Disease and Therapeutic Index, we analysed the medication prescription patterns for six classes of medications from 2010 to 2014 among patients, 35 years or older, with diabetic nephropathy...
March 15, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28276512/the-efficacy-and-safety-of-sglt2-inhibitors-for-adjunctive-treatment-of-type-1-diabetes-a-systematic-review-and-meta-analysis
#14
Jiao Chen, Fang Fan, J Y Wang, Yang Long, C L Gao, R C Stanton, Yong Xu
To assess the efficacy and safety of the SGLT-2 inhibitors as adjunct therapy to insulin in T1DM, clinical trials indexed in PubMed, Cochrane Library, EMbase from inception through April 5, 2016. A meta-analysis was conducted on trials of SGLT-2 inhibitors in patients with T1DM on insulin therapy using RevMan 5.3 software. Of the 371 articles identified, ten met eligibility criteria. Seven clinical trials including four randomized controlled trials and 581 patients were included. Compared with the control group, SGLT-2 inhibitors group had significantly reduced fasting plasma glucose by 0...
March 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28244288/characteristics-and-impact-factors-of-renal-threshold-for-glucose-excretion-in-patients-with-type-2-diabetes-mellitus
#15
Xiao Dan Yue, Jing Yu Wang, Xin Rong Zhang, Ju Hong Yang, Chun Yan Shan, Miao Yan Zheng, Hui Zhu Ren, Yi Zhang, Shao Hua Yang, Zhen Hong Guo, Bai Chang, Bao Cheng Chang
Sodium glucose co-transporter 2 (SGLT-2) inhibitors are newly developed but promising medicine for type 2 diabetes. However, patients with a different renal threshold for glucose excretion (RT(G)) may have a different reaction to this medicine. Therefore, the objective of this study was to investigate the characteristics of RT(G) and its impact factors in patients with type 2 diabetes mellitus (T2DM). The clinical and laboratory data of 36 healthy individuals and 168 in-hospital patients with T2DM were collected and analyzed, RT(G) was calculated using blood glucose (BG) measured by dynamic BG monitoring, urinary glucose excretion (UGE) and estimated glomerular filtration rate (eGFR)...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28222461/elements-for-success-in-managing-type-2-diabetes-with-sglt-2-inhibitors-individualizing-treatment-with-sglt-2-inhibitor-therapy-in-type-2-diabetes-mellitus
#16
Eden M Miller
The largely self-managed nature of type 2 diabetes mellitus (T2DM) underscores the importance of a collaborative decision-making process between patient and provider that best aligns the medication characteristics with the needs, interests, and abilities of the patient and with the treatment goals. The treatment regimen should be kept as simple as possible. This article applies these general principles to the use of sodium glucose cotransporter-2 inhibitor (SGLT-2) therapy, based on evidence from published studies and the clinical experience of the author...
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28222460/elements-for-success-in-managing-type-2-diabetes-with-sglt-2-inhibitors-overview-of-the-efficacy-and-safety-of-sglt-2-inhibitors-in-type-2-diabetes-mellitus
#17
Eden M Miller
Since the approval of the first sodium-glucose cotransporter-2 (SGLT-2) inhibitor by the US Food and Drug Administration (FDA) in 2013, the SGLT-2 inhibitors have assumed key roles in the management of patients with type 2 diabetes mellitus (T2DM). This review covers the safety and efficacy of these agents when used in this patient population.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28222459/elements-for-success-in-managing-type-2-diabetes-with-sglt-2-inhibitors-role-of-the-kidney-in-glucose-homeostasis-implications-for-sglt-2-inhibition-in-the-treatment-of-type-2-diabetes-mellitus
#18
Eden M Miller
The focus on the kidney as a therapeutic target for the treatment of type 2 diabetes mellitus (T2DM) has led to the development of the sodium-glucose cotransporter-2 (SGLT-2) inhibitors, of which 3 are available in the United States. This article addresses the implications for SGLT-2 inhibition in the treatment of T2DM.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28196866/sglt2-protein-expression-is-increased-in-human-diabetic-nephropathy-sglt2-protein-inhibition-decreases-renal-lipid-accumulation-inflammation-and-the-development-of-nephropathy-in-diabetic-mice
#19
Xiaoxin X Wang, Jonathan Levi, Yuhuan Luo, Komuraiah Myakala, Michal Herman-Edelstein, Liru Qiu, Dong Wang, Yingqiong Peng, Almut Grenz, Scott Lucia, Evgenia Dobrinskikh, Vivette D D'Agati, Hermann Koepsell, Jeffrey B Kopp, Avi Z Rosenberg, Moshe Levi
There is very limited human renal sodium gradient-dependent glucose transporter protein (SGLT2) mRNA and protein expression data reported in the literature. The first aim of this study was to determine SGLT2 mRNA and protein levels in human and animal models of diabetic nephropathy. We have found that the expression of SGLT2 mRNA and protein is increased in renal biopsies from human subjects with diabetic nephropathy. This is in contrast to db-db mice that had no changes in renal SGLT2 protein expression. Furthermore, the effect of SGLT2 inhibition on renal lipid content and inflammation is not known...
March 31, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28190822/phloridzin-inhibits-high-k-induced-contraction-via-the-inhibition-of-sodium-glucose-cotransporter-1-in-rat-ileum
#20
Hidenori Kanda, Takeharu Kaneda, Akira Kawaguchi, Noriyasu Sasaki, Tsuyoshi Tajima, Norimoto Urakawa, Kazumasa Shimizu, Hiroetsu Suzuki
Recent studies have shown that phloridzin, an inhibitor of sodium-glucose cotransporter (SGLT), strongly decreases high K(+)-induced contraction in phasic muscle, such as tenia coli, but slightly affects tonic muscle, such as trachea . In this study, we examined the inhibitory mechanism of phloridzin on high K(+)-induced muscle contraction in rat ileum, a phasic muscle. Phloridzin inhibited the high K(+)-induced contraction in the ileum and the aorta, and the relaxing effect of phloridzin at 1 mM in the ileum was approximately five-fold more potent than that in the aorta...
March 23, 2017: Journal of Veterinary Medical Science
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